Background

This study prospectively evaluated the impact of a complete smoking bar on a locked psychiatric unit.

Method

The setting was a 16-bed inpatient unit with 83% (134/162) involuntary patients, no off-unit smoking area, no possibility of granting smoking passes, and a mean length of stay of 2 weeks.

The effect of a complete smoking bar was measured by surveys of both staff and patients before and after the ban.

In addition, objective indicators of ward disruption were measured, including rates of aggression, use of p.r.n. medications, need for seclusion and restraints, elopement, and discharges against medical advice.

Results

Although staff initially expressed concern about the ban's potential negative impact, after it began, t tests revealed that staff were significantly (p

Staff were significantly (p

Although patients, overall, had negative views toward the new policy, their opinions were somewhat less negative after its implementation.

Rates of assaultive behavior, use of seclusion and restraints, use of p.r.n. medication, and against-medical-advice or elopement discharges did not change after the bar was in effect.